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Item #9
Metformin
Linked to Reduced Risk of Mortality
When
treatment with metformin was compared to sulfonylurea treatment, study
showed a 24.7%,
reduction.
In
a retrospective population-based cohort study, treatment with
metformin, alone or in combination with sulfonylurea, was associated
with a decreased risk of mortality compared with sulfonylurea
monotherapy.
"Our
results refute previous epidemiologic studies suggesting that
metformin is associated with increased mortality in type 2
diabetics," Canadian researchers write in the December issue of
Diabetes Care.
Dr.
Jeffrey A. Johnson and colleagues from the University of Alberta in
Edmonton analyzed mortality in 3033 and 1150 "new users" of
sulfonylurea or metformin, respectively, as well as 4683 new users of
both agents. They defined new users as individuals with prescriptions
for sulfonylurea or metformin between 1991 and 1996 and no use in the
prior year.
During
an average follow-up of 5.1 years, mortality rates among subjects with
at least 1 year of drug exposure and no insulin use were 24.7%, 13.8%,
and 13.6% for subjects taking sulfonylurea monotherapy, metformin
monotherapy and combination therapy, respectively.
Compared
with sulfonylurea monotherapy, the adjusted odds ratio for all-cause
mortality for metformin monotherapy was 0.60, the team reports.
"Sulfonylurea plus metformin combination therapy was also
associated with reduced all-cause mortality," they report, with
an odds ratio of 0.66.
The
data suggest a reduction in cardiovascular-related mortality rates in
metformin users compared with sulfonylurea users.
Dr.
Johnson and colleagues suggest in their report that previous studies
linking metformin use to increased mortality risk did not have
sufficient numbers of subjects or events to evaluate mortality
adequately. Diabetes
Care 2002;25:2244-2248.
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